It is also self-inflicted skin damage, most commonly from prolonged deliberate scratching, but sometimes by means of sharp instruments or another agency.

[1]: 391 [2]: 61 The cutaneous lesions that are commonly seen are unusual, resembling numerous recognized inflammatory responses in the skin.

[3] When a false history is given, it is typically "hollow," with no explanation of how specific skin lesions that develop on easily accessible areas suddenly become fully formed.

[4] Inducing lesions is a psychological strategy used by the patient to satiate an internal need, most commonly the desire for attention or care.

Several psychosocial difficulties, emotional immaturity, unconscious motives, and dysfunctional interpersonal relationships have all been identified as etiological factors.